透过“反”字论伤寒  

Discussion About Treatise on Cold Damage Diseases Through the Word "Fan"

作　　者：孔梦琦 王宁 KONG Meng-qi;WANG Ning(Shandong University of Traditional Chinese Medicine,Shandong,China,250000;Haici Medical Center of Qingdao,Shandong,China,266000)

机构地区：[1]山东中医药大学,山东济南250000 [2]青岛海慈医疗集团,山东青岛266000

出　　处：《河南中医》2022年第5期656-658,共3页Henan Traditional Chinese Medicine

摘　　要：《伤寒论》中包含“反”字条文者,大部分与症状相关,“反”字之前多为各经病证中的普遍症状,“反”字之后则为与六经普遍症状相矛盾的特殊症状,而这些“反”字之后的特殊症状往往揭示该病病机。在带有“反”字的条文中,除了描述症状,也有部分条文阐述脉象,所阐述的脉象反映关键病机。有条文提及了各经病证经医“反”治后产生的系列变证,提示医者要把握病机,根据表里证候的轻重缓急选取相应治则。在诸多指导用药的条文中,有部分条文的用药在“反”字之后,提醒后世医家要在辨证论治的基础上,根据病性选择用药。“反”字在理解条文含义方面也具有重要作用,突出了从普遍到特殊的辨证论治思维。但临床实践中,不能单单着眼于“反”字之后的特异性症状,更要分辨出整体病情是否符合“反”字之前的普遍症状,从而培养从普遍到特殊的临床思维能力。In Treatise on Cold Damage Diseases,most of the articles containing the word "Fan" are related to symptoms.Before the word "Fan",there are mostly the common symptoms of various meridians,and after the word "Fan",there are special symptoms that contradict the common symptoms of the six meridians,and the special symptoms after these words often reveal the pathogenesis of the disease.In the articles with the word "Fan",in addition to describing the related symptoms,some articles also describe certain pulse condition,which reflects the key pathogenesis.Some articles refer to a series of deteriorated syndromes after the "Fan" treatment of various meridians′ syndromes,suggesting that doctors should grasp the pathogenesis and select the corresponding treatment principles according to the order of priorities of the syndromes in the exterior and interior.In many articles guiding drug use,some ones of drug use after the word "Fan" remind future doctors of choosing drugs according to the nature of the disease on the basis of syndrome differentiation and treatment.The word "Fan" also plays an important role in understanding the implication of the articles,highlighting the thinking of syndrome differentiation from universal to special.However,in clinical practice,we should not only focus on the specific symptoms after the word "Fan",but also distinguish whether the overall condition conforms to the common symptoms before the word "Fan",so as to cultivate the clinical thinking ability from universal to special.

关 键 词：《伤寒论》 “反”字 六经 张仲景 

分 类 号：R222.2[医药卫生—中医基础理论]